Anxiety is common among physicians who need to obtain secretions from the vagina of a prepubertal child. Because children rarely comply with these procedures, there is a chance of iatrogenic damage to the thin, delicate, unestrogenized mucosa of the genital tract. Furthermore, because these procedures can have long-lasting psychosocial effects, manipulation of the genital tract should be performed cautiously.
Techniques described in most textbooks for obtaining vaginal secretions are far from ideal. Altcheck, A. Pediatric vulvovaginitis. J. Reprod. Med. 29:359-375, 1984. Emans, S. J. and Goldstein, D. P. Pediatric and Adolescent Gynecology. Little, Brown and Company, Boston, 1982. p.47. They can be traumatic and yield only small amounts of material. Q-tips are abrasive to the unestrogenized mucosa and should not be used. Eye droppers, pipettes, and plastic cannulas are smooth and unabrasive, but can cause trauma due to inadvertent patient movement. Any single chambered tube or cannula placed in these small vaginas will be sucked against the vaginal wall when an effort is made to withdraw secretions, making the yield of material very small. Furthermore, the suction frequently alarms the child.
Many children with vulvovaginitis go through needless courses of creams and antibiotics because the infectious organism is never identified. Many children who have been sexually exploited have their story unsubstantiated because material for forensic rape kits and/or cultures is never obtained. Through the use of the present invention the management of children with these common pediatric gynecology problems will be improved.